CMS Formulary

Displaying 15811-15820 of 1611142 results.
ID: 15811
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 317174
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 15812
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 312745
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 15813
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 616483
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 15814
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 312743
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 15815
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 312840
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 15816
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 314209
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 15817
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 199206
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 15818
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197805
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15819
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197806
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15820
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197807
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0